Provider Demographics
NPI:1003372657
Name:GRISWOLD, JERRY GRANT II (NURSE'S AIDE)
Entity Type:Individual
Prefix:MR
First Name:JERRY
Middle Name:GRANT
Last Name:GRISWOLD
Suffix:II
Gender:M
Credentials:NURSE'S AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 W 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3231
Mailing Address - Country:US
Mailing Address - Phone:303-433-3944
Mailing Address - Fax:303-433-9717
Practice Address - Street 1:2829 W 33RD AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3231
Practice Address - Country:US
Practice Address - Phone:303-433-3944
Practice Address - Fax:303-433-9717
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No376K00000XNursing Service Related ProvidersNurse's Aide